The explosion in ADHD and autism diagnoses is being fuelled by the ‘marketing strategies’ of private clinics that convince Britons that they have a disorder for profit, leading experts have warned.
Top medics in the field have described the array of treatment providers as the ‘wild west’, accusing them of ‘exploiting’ vulnerable adults who are seeking ‘self-understanding’ and ‘identity’.
As a result many diagnoses – often delivered by ‘less qualified’ staff – may be incorrect, they suggest.
Writing in the British Medical Journal, autism pioneer Professor Dame Uta Frith and clinical psychologist Dr Naomi Fisher called for strict regulation of private providers.
The experts also argued for clearer criteria for diagnosis, describing the current requirements as ‘elastic’.
‘What we mean by autism and ADHD has changed both formally and informally,’ they wrote.
‘This makes them ripe for exploitation by providers who see ADHD and autism assessments as a business opportunity.
‘Convincing more people that they could be autistic or have ADHD is a marketing strategy to increase their customer base. Giving more people the diagnosis makes business sense because a dissatisfied customer who does not receive the diagnosis they hoped for may leave poor reviews or complain.’
Professor Dame Uta Frith (pictured) and clinical psychologist Dr Naomi Fisher warned that ‘convincing more people that they could be autistic or have ADHD is a marketing strategy’
The assertions come weeks after a major report concluded that Britain risked harming a generation of children by overdiagnosing the conditions – potentially pushing them towards unemployment and a life on benefits.
Diagnoses of ADHD are at record highs in England – rising 20-fold since the turn of the century – while autism cases increased by 787 per cent in the UK between 1998 and 2018.
Earlier this month, the review, led by clinical psychologist Professor Peter Fonagy, found schools and welfare systems were rewarding the ‘labels’ of ADHD and autism.
The report found that children diagnosed with ADHD before 17 are around four times less likely to be in education, employment or training in early adulthood, with each youngster in this situation costing taxpayers £244,000 over their lifetime.
Like Professor Frith and Dr Fisher, Prof Fonagy raised concerns about the ‘consistency and quality’ of assessments for the conditions carried out privately.
Today, private firms conduct more than half of NHS-funded ADHD assessments and a third of autism ones.
This is because demand has outstripped supply in many local areas, forcing NHS bosses to farm some mental health services out to private health companies.
Experts say the situation is worsened by England’s Right to Choose scheme, which entitles patients to opt for an NHS-approved alternative provider if waits for local services are too long.
Experts have warned that private services are poorly regulated and are allowed to advertise their services directly to potential customers, while the NHS bears the cost.
‘Private providers generally have an incentive to increase demand through marketing and to provide assessments as cheaply as possible to expand their profit margins,’ wrote Prof Frith and Dr Fisher.
‘This may mean employing less qualified staff and cutting the time allocated for each assessment.’
Speaking to the Mail, Dr Fisher recalled working for a private clinic that carried out online ADHD assessments. She claims that the chief executive of the firm had no healthcare training.
‘NHS waiting lists seemed to be a business opportunity,’ she said. ‘The pressure was to do the online assessments in as short a time as possible.
‘When healthcare becomes a profitable enterprise, all the incentives change. I left quickly because it felt so wrong to be giving children life-changing diagnoses under those circumstances.’
Diagnoses of ADHD and autism are based on an assessment of the person’s difficulties, developmental history and degree of functional impairment.
There are no measurable biological markers in the body that signal the conditions, meaning whether or not a patient has the conditions is often open to interpretation.
The experts likened the growth in ADHD and autism diagnoses to a vicious circle.
First, rising demand prompted by ‘greater social importance’ prompts an increase in assessment providers.
Greater availability of assessments then leads to more diagnoses which, in turn, encourages more people to consider their distress may be due to ADHD or autism, Prof Uta Frith argued.
‘One of the ways in which private clinics can increase demand is by expanding the number of people who think that an ADHD diagnosis might provide the answer to their problems,’ Dr Fisher added.
‘Many of us now see these types of adverts on a daily basis and they are all over social media. These have the potential to change the way that people think about themselves.
‘They encourage people to think that their struggles in life are due to a diagnosable disorder which has a medical treatment – and to therefore seek an assessment.’
According to analysis by comparison site ADHD Private, just two UK companies adopted ‘ADHD’ in their name in 2015.
By 2025, that figure had risen to 120, while a further 79 had done so by September 2026.
Prof Frith and Dr Fisher stressed that they do not wish to refuse help for people with the conditions who are in distress.
But they warned that the assessment system is not being used in the way it was designed to.
‘When people are encouraged to understand themselves through a system never intended for this purpose, that system is bound to break down,’ they said.
After the report, Health Secretary Yvette Cooper pledged last month to strengthen mental health services.
She said the Government will ‘make all diagnostic assessments for ADHD and autism CQC-regulated’ so that people can be ‘confident that assessments are high quality and the NHS is not being overcharged by private providers’.
